Sunday, September 27, 2009

From the September 20th issue of the English newspaper the telegraph, a quote from Obama: “"I can't tell you how many foreign leaders, who are heads of centre-right governments, say to me 'I don't understand why people would call you socialist, in my country you would be considered a conservative'," Mr Obama told CNN.” Of course, consider the source. Obama lies constantly, or so Jack Kelly would (likely) maintain.

Interestingly, for today’s column, Kelly chose not to write about the G20 or the revelation that Iran is building a facility that might make nuclear weapons. Instead Kelly decides to comment on Obama’s support of Manuel Zelaya, who Kelly says the administration “wants to install as president of Honduras over the objections of the overwhelming majority of its people”.

Before examining that statement, lets look at the history of Zelaya. He was elected President in 2005, so I guess the overwhelming majority did not object to him at the time. He apparently decided he wanted to serve another term, but apparently Honduran law or the constitution allow Presidents to serve only one term. Zelaya apparently petitioned the Honduran Congress to hold a referendum to change the law/constitution, the Congress refused and Zelaya apparently had some ballots printed up anyway. If all that is true, and I am wiling to take Kelly’s word for it until/unless I read otherwise (from a reputable source), then Zelaya is an idiot. However, assuming Kelly’s argument that the people don’t support Zelaya is also true, then a referendum would be harmless, and in fact provide support for the system. Now, I will say I don’t know how constitutional change is supposed to work in Honduras, so what Zelaya is trying to do might be underminig the system.

In any event, what happened next is the real issue. The Attorney General petitions the Supreme Court to issue an arrest warrant for Zelaya, which they do, and the President is sent into exile by the army. Now, if Zelaya is not supported by the people (as Kelly says), then why bother? Kelly would have preferred Zelaya be imprisoned and put on trial, but even then, why bother? But from the Obama administration’s point of view, taking these steps is a pretty serious shortcut of political process. I can see the point of issuing sanctions (or having Congress vote on them) and insisting Zelaya be reinstated. If we are serious about democracy, we can’t just support democratically elected leaders we like.

Now, I write all this not knowing the detail of situation in Honduras. Most of what I am writing is based on what Kelly wrote. I am willing to admit that if what Kelly wrote is all the detail of the situation for Zelaya, then Zelaya does sound like an idiot. Still our reaction to a Democratically elected leader being deposed is not surprising. Especially since Kelly makes it sound like if the Honduran opposition to Zelaya had waited a couple of months it would have all been over anyway.

As I said above, the fact that Kelly wrote about this and not Iran or the G20 speaks volumes about Kelly’s attitude towards Obama. Kelly makes a relatively incoherent attack on a minor foreign policy situation while ignoring what is happening in Iran with nuclear weapons and what is happening on the world economic stage. Kelly simply wants to find any mistake, no matter how far fetched, he can pin on Obama. The PG needs to think about that.

Friday, September 25, 2009

Just one observation from the G-20 protests. You tell people that they are the people you are protesting and fighting for – Americans of color, working class people, students. You go to their neighborhoods, you talk to them, spend time with them. Then the marches start, the confrontations with police, and then you are breaking windows. In the neighborhood where the march started, the working class neighborhood. The neighborhood where the people you are supposedly fighting for live. You are smashing the windows of their restaurants. And you wonder why Americans of color and/or working class people don’t appreciate your efforts.

On the other hand, P&W Motors, Mercedes of Shadyside (Bobby Raihal), whichever, good job.

Thursday, September 24, 2009

Well, I plan to write about the G-20 (apparently now after the fact) and I plan to look at local politics, but I am still somewhat consumed by healthcare/insurance. I want to challenge any opponent of healthcare/insurance reform to read what I have written below and then tell me why we shouldn’t reform the system. When people say the system is broken, I think they are understating the issue.

As I understand it, health insurance came about in World War II, when there was a government imposed wage freeze. Now, lots of people were working, and companies still wanted to produce more … I guess tanks and uniforms, mostly, so they wanted to lure better workers to their plants. Health insurance allowed them to differentiate themselves. I believe early health insurance simply paid the doctor bills. I believe at some point in the next forty years doctors discovered if they raised their prices insurance companies would grumble but still pay.

Fast forward to the 1980’s, where the increase in health care costs and the corresponding increase in health care premiums has caused a crisis. See, the way employer based health insurance worked was that at first, the company paid it all. As premiums increased, companies started tinkering with their employee’s plans, creating and then increasing co-pays and having employees contribute to the premiums of their plan. But by the 1990’s health insurance is becoming a crisis, and Bill Clinton tried to implement universal health care. It was defeated, partially because of tactical errors on Clinton’s part, but also because of the alliance of the health insurance giants and the Republicans. For practical reasons the health insurance industry did try to reform itself (it was in danger of killing the goose that laid the golden eggs) through mechanisms like HMO’s and preferred provider options. In particular, at some point probably in the late seventies, health insurance companies started saying they would 80% of the usual, customary and reasonable costs charged by doctors in that particular geographic area. The doctors would receive less money but be guaranteed payment, and agree not to charge the patient the twenty percent. The insurance companies could enforce this by creating networks (where the doctors agreed to these rules) and only paying out of network doctors fifty percent of their charge (this is usually called blackmail). Now, as I suggested at some point I think doctors (and hospitals) started at some point milking the system when they had previously found insurance companies would pay the whole bill, and this new system reinforced the notion that it made sense for all doctors to find excuses to raise their rates every year, if only to increase that 80%. But you can imagine the effect on the uninsured. Every year, it becomes more and more dangerous financially to go to a doctor or the emergency room. Doctors desperate to maintain their life style and hospitals that want to remain profitable are raising their prices to astronomical levels (one night in the hospital for me according to insurance: 11 grand).

Another piece of this puzzle is that companies are still largely shielding their employees from the bulk of the cost of health insurance premiums. Apparently health insurance can cost 12 grand a year for an employee with a family of four, of which I believe companies might charge the employee three grand (I don’t know for sure, I never priced the family plans at work). To some extent, this used to work out ok because companies take a tax deduction on that part of the employees wages, as do the employees on the part they pay (look at your W2). This gave companies an incentive to offer health insurance (the health insurance companies had to agree not to deny or drop coverage based on pre-existing conditions). But I think the costs are now outstripping the tax advantages and in fact have been for a while. Where does the balance of them money come from? The price of everything. It is a hidden tax, administered by everyone and controlled by no one. So the tuition at CMU is higher than it would be if there was a government paid plan. And make no mistake, yes, with a government run single payer plan your taxes would be higher, but your wages ought to go up and prices for products ought to go down. Plus there would be fewer bankruptcies caused by people with no or inferior health insurance going to the hospital. In fact, many low wage employees would be more productive than before because they would have no fear of going to the doctor and would get health problems treated and would have other problems averted with preventative care. Say what you want about preventative care, if you have a sore throat and go to the doctor and find out it is a staph infection, get it treated and get better, that is a better result than going to the emergency room and still dying, and sticking your family with outrageous bills.

A third piece of this puzzle is that health insurance companies in the US return a smaller amount of their premiums to claims people make than health insurance companies in other countries. Which is to say for every premium dollar US health insurance companies take in, they pay out about 80 cents. In other countries the amount is about 95 cents paid out. The US pay out rate is looked upon favorably by Wall Street, it means the companies are being that much more profitable, and can give that much more to investors (and higher level executives in the company as well). This level of profitability is only sustainable if the insurance companies can continue to deny and drop coverage on people with pre-existing conditions (those not in employer offered health plans).

I didn’t address medical malpractice. I was chatting with a lawyer the other day (a whole ‘nother story I will have to say something about soon) and he was saying that two groups that do a lousy job of “policing” themselves are cops and doctors. I think that malpractice needs to be treated carefully. I think that people who are harmed by doctors through negligence should be recompensed. I think we also need to take steps to make sure that doctors who make more than one serious mistake are dealt with in some manner, whether it is being given the option of giving up their license or taking some huge amount of remedial training or something else, I don’t know. But something does need to happen, and if Republicans want to make a big stink about that, that is one area were I will cheer them on.

There are probably issues I have omitted (pharmaceuticals come to mind), but surely you are getting tired (I am).

So I talked about three of the five participants in the US health care system: health care providers, health insurance companies and private employers. The other two participants are the customers (us the US) and the government. Of those first three, providers and insurance companies have perverse incentives, and private employers are unwilling co-conspirators in making everything more expensive than it really needs to be. Healthcare/insurance reform needs to address the first two issues at the very least, and if we adopted a single payer plan that would address the issue of how much employers are spending on health insurance for their employees.

Meanwhile, we, the customers of health care (all of us) and customers of health insurance (85% of us) are being influenced in interesting ways. I would think that if most people see the issue the way I stated it above, they would be in favor of healthcare reform. In fact, I can see no arguments for maintaining the status quo. Even if you are a well compensated health insurance executive, unless you can pull off living in another country you are still paying more for ordinary goods and services than you should have to.

Yet conservative entertainers have given us outright lies to try to frighten us into thinking that health care/insurance reform is some sort of plot to destroy the country. The effect may be that of the legislative branch of the fifth participant in health snafu, the government, just enough Democrats and all Republicans save maybe one or two will vote against all but the weakest plan for reform (basically a giveaway to health insurance plans) in the Senate. We have the power to do something about that, but we have to act. Anytime anyone says that healthcare/insurance reform is a plot to overthrow democracy, ask them how that is, specifically.

I don’t want to pretend that health care/insurance reform will be easy. It would be difficult to address the current salaries of doctors, for example, they will protest they should have to give anything up. Even if they don’t have to pay as much in malpractice insurance, even if prices come down, doctors will want to make at least as much next year as they did this year. But we do need to do something, and probably more than what is in Max Baucus’ bill.

Sunday, September 20, 2009

Jack Kelly wrote a mean little column today, where his main point is that Joe Wilson was right when he yelled “You lie” at Obama during his health care speech to Congress. Forget whether it was rude or unprecedented, it was apparently justified. Although one of the bills working its way through the House does have explicit language saying that illegal aliens are not supposed to benefit from government sponsored health insurance, another part of this bill says that administrators signing people up for health insurance are not supposed to be Immigration and Customs Enforcement agents; they are not supposed to ask for citizenship documents.

I don’t know, I realize Kelly is some sort of former marine, and feels that people who work for the government should be enforcing its laws. But if I apply for a job to sign people up for health insurance, I don’t expect to be arresting people and detaining them so they can be deported. And what kind of society do we want to live in?

Meanwhile, it is not exactly like people will get much just by signing up with government provided health care. It is supposed to be cheaper than private insurance, but it is also supposed to pay for itself. This is not where the tax dollars are supposed to go. There are supposed to be subsidies for low income people, and maybe that is where some attention should be paid.

As for whether your employer could drop your coverage when the government expands healthcare (which Joe Wilson neglected to yell about, guess Republicans don’t care about millions of working Americans), that could happen at any time, for any reason. And sometimes that’s a good thing, if, for example your employer finds a more cost effective plan. Now I think the President or someone said that at lest some of the bills prevent the public option being offered to people who have health insurance already. But I don’t know how that will work out in practice. And actually, it could be a good thing if employers shed them selves of the burden of providing health insurance, if there is a fair alternative available, and if the employees get a ten thousand dollar raise (after all, Europe is coming, Europe is coming).

Meanwhile, I don’t think illegal aliens lead all that nice a life. Many without health insurance doing jobs like working on roofs and ladders, or working all night cleaning offices. They can be mistreated almost at will, because calling the labor department would get them fired, and possibly deported. We need to address the issue of undocumented workers in an adult way. But meanwhile worrying about them in a healthcare bill is simply a distraction, one that the Republicans are shoving down our throat.

Thursday, September 17, 2009

I thought of two funny things yesterday (well, I thought they were funny), but right now I can only remember one. I think we can coin a new word: “Obama’d”. That’s when a Democrat reaches out to Republican legislators by gutting a piece of legislation and trying to give them what they want, and the Republicans, who had previously listed all these things they wanted, refuse to sign on to the bill. And for the first instance of someone being Obama’d: Senator Max Baucus.

Tuesday, September 15, 2009

Color me particularly stupid, in what is now becoming a bad pun. I had failed to make the connection between Color of Change (the organization that started an advertiser boycott of Glenn Beck’s program after he called President Obama a racist) and Van Jones (a co-founder of Color of Change, now not affiliated with it).

The parenthetical remarks covered it all.

The NYTimes Opinionator had an interesting compilation of various points of view entitled “Is it because he’s black?”, on an obvious topic. The last entry, a comment made by a reader of Andrew Sullivan’s Atlantic column, was, to me, the most interesting. He suggests that the Republican/conservative hatred of Obama is deeper than mere racism. This commenter called it "shadow projection", and he started with one of my favorite themes, that no one thinks of themselves as a bad person. But the US, under the Republicans for the last eight years (yeah, yeah, Congress for four) has done bad things to itself and others. Two wars, at least one justified with lies, the patriot act (wiretapping ourselves), spending, rolling back regulation with predictable results of an economic meltdown… In the past, these sorts of things would have been projected (essentially blamed or at least justified by) on an external opponent, such at the Soviet Union or maybe Iran. But now we have no credible external opponent (China can only threaten us economically, and instead they are buying our T-bills). Instead, the threat has been chosen from within: Obama. So now Obama is accused of financial irresponsibility with the stimulus package despite the spending during the Bush years, Obama is accused of trying to indoctrinate our children with his speech despite the indoctrination during the Bush years of a particular sort of Bush-worshiping patriotism, Obama is accused of trying to destroy the economy with new regulation when the deregulation of the Bush years nearly caused a depression. As Obama tries to move forward with new proposals (that try to address past failings of government), they are cast by Republicans/conservatives as some new evil having some negative consequence As the commenter puts it “The more evil revealed about the right’s excesses on torture, or wars of choice, or nearly destroying the economy, the more evil Obama will look in their eyes, as they cannot tolerate owning responsibility, because in their own minds they are only good.” And the commenter ends with “This will not end well. Now that Obama is carrying their shadow, only a dramatic event from outside could change it. . . . The more those on the right deny their own failings, the more their internal unease will increase, the more the hatred to Obama will grow, and the more the need to do something will increase.”

Monday, September 14, 2009

An addendum to today’s post; Congresspersons who are Democrats are likely to be hesitant to comment negatively on the lies perpetrated by conservative media figures which are picked up by Republican/conservative politicians and party officials. The Democrats are hesitant to push back because they don’t want to be in the position of insulting the beliefs of some of their constituents. Which is too bad, since otherwise people walk around believing these stupid myths and conspiracy theories.

I should mention Glenn Beck’s 9/12 rally in DC, on Friday or Saturday. Apparently one of the organizers simply lied and said that 2 million people were present. I have heard 70,000 from a few (possibly charitable) people like Nate Silver, or as low as 60,000. That’s a lot of people, but for a supposedly nationwide effort? That speaks for itself.

Color me stupid, and maybe (probably, I hope) what I am seeing is more like a marriage of convenience than a conspiracy, but Ross Douthet’s column today in the NYTimes pushed me further toward thinking that Republicans/conservatives really are manufacturing their own reality. Douthet’s column is about how similar this time is to 1994, when the Republicans overturned a Democratic majority in Congress. Then, of course, the Democrats had controlled the Congress for decades, now its been three years, and of those three years the Republicans have done their best to be obstructionist and set records in the Senate for these phantom filibusters (make ‘em actually do it, and pee their pants). Douthet includes lines like “The health care push has opened up arguments about abortion, euthanasia and illegal immigration that the Democrats would rather avoid.” Except that those arguments are flat out Republican lies, spread by the likes of Glenn Beck, Rush Limbaugh and Sarah Palin. Douthet doesn’t mention that. Yes, health care bills in Congress have end of life counseling, something Senior citizens want and until recently, so did Republicans. And the only way health care bill in Congress have anything to do with abortion or illegal Aliens is in describing how they will not be covered.

But the fact that Ross Douthet is talking about this that way in the New York Times made me realize that this is the way things are, at least during Democratic Presidencies. A Glenn Beck, Rush Limbaugh or Sarah Palin starts a lie, like abortion, euthanasia or illegal immigration in the “health care bill” (as if there was only one). These lies are aimed at their most gullible followers, the religious right or rural conservatives. These followers go to town hall meetings or protest rallies, and some get their faces on TV for ten seconds. Others want that, and the ranks swell (not by really that much, but enough). Polls are affected negatively for the Democratic President, not by a surprising amount, but in Obama’s case the depth of the support for his candidacy was imagined by the press, so any slide is seen as a major revolt. And so the “legitimate” and “reasonable” conservatives pundits step in and say that a majority of the country now opposes the President’s plan, whatever it is. They would say that while the bill doesn’t have euthanasia in it, the end of life counseling seems like you are pushing grandma towards the light, and anyway there are other signs there is Medicare rationing in “the bill”. I have heard David Brooks accuse the President of telling “whoppers” (lies), without spending one minute discussing the President’s accusers.

So there is a dynamic, where the fringe talk radio (and TV) wackos whip up an uneducated base, who complain loudly and publicly, and in turn the “thoughtful” conservatives identify an important movement in America, and describe it as a majority. The problem is this is having a real impact on policy. The public option is now in real trouble, which of course is what the insurance companies want. In fact, meaningful health care insurance/reform is in real trouble. Of course, some liberals aren’t helping either. Obama gives a tough speech, and Bill Maher acts like he wants Obama to physically beat conservatives. STOP TRYING TO HELP, Mr. Maher. The last thing Obama wants to do is hand the Republicans the gift of becoming “the angry negro”. Or did you miss what happened to Van Jones, and more importantly, why?

Sunday, September 13, 2009

“From each according to his (or her) ability, to each according to his (or her) need”. A big idea in Marxism, not to say communism. I have always considered Marxism to be an impressive philosophy, particularly in the way it approaches work. It says that we define ourselves by our work, and trading our work for currency (particularly a small amount of currency) degrades us. I guess though if we see our work as directly helping others (in the mythical workers paradise), even as they direct help us, it is more rewarding to our souls.

Of course, anyone who was willing to look with open eyes could see the that the Soviet Union and China were not worker’s paradises. The closest one might come to that would likely be in western Europe, and even in those countries there are plenty of disgruntled workers.

It was maybe a different story in the 1920’s and 1930’s, where the people likely to become communists in the US, the workers, couldn’t really travel to the Soviet Union (and the People’s Republic did not exist yet). Especially during the thirties, Communism must have seemed like an attractive alternative to Capitalism.

I am thinking about this because of Jack Kelly’s column today. My first thought reading it was, so there is only one way to be political in this country. We are the land of the free, yet Kelly suggested that only a few years ago Jones would not have been allowed in the White House (and then you have to say it, does Kelly mean because Jones was briefly a communist, or because Jones is black).

Kelly wants to say (I am extrapolating here) Jones never stopped being a communist, and that automatically should exclude him from any kind of government service, certainly from service in the White House. But I have to say the Van Jones did not behave like a prototypical communist, certainly not one that wanted the workers to rise up and seize the means of production. At this point, in fact, I am not sure what that means (I think the “workers” might need to look like nerds, since I guess they would be seizing netbooks and servers).

But Van Jones was the wussiest Marxist/Communist I have ever seen. He was part of a radical group called STORM (STANDING TOGETHER TO ORGANIZE A REVOLUTIONARY MOVEMENT), which protested the Rodney King verdict and the anniversary of Christopher Columbus “discovering” America. Jones himself is credited with joining and/or starting groups in the nineties that monitored police brutality, obtained books for convicts and protested the first gulf war. One of these efforts succeeded in getting a policeman accused of brutality fired. Hardly the sort of stuff to topple the US government.

Around the turn of the millennium, Jones figured out that if poor people got better jobs, they would gain more economic and therefore political power, which inspired Jones to look at “green” jobs for poor people. Kelly makes it all sound so sordid, but if you consider the context, Jones has simply pointed out the situation of poor people of color, and worked to change it, or at least keep it from becoming worse, always working within the system, legally. And his reward for doing so was to be hounded from the white House, with unelected “pundits” responsible to no one (like Glenn Beck and Jack Kelly) leading the charge. I guess, despite our “freedoms”, there is only one way to be political in this country.

Friday, September 11, 2009

As I wait at work, waiting to hear from my brother who missed a flight waiting in line at security, I think about today as anniversary, and irony. I remember well where I was 9/11/01, working in the Cathedral of Learning on the 30th floor. Our receptionist told us (me) a plane had crashed near by, and that something seemed to be going on in New York. I was skeptical about all that, but I tried the New York Times website and found it wasn’t loading (which rarely seemed to happen, even in those days). People grew panicky as we realized what had happened. Would the cathedral be the next target, a tall building standing alone in Oakland? No one said, but I assume several people were thinking of Pitt’s considerable foreign student population. Around noon we got word from Nordenberg’ office that we should go home. I waited until most people were off the floor to leave, not willing to trust the Cathedral’s notoriously unreliable elevators would handle one more person crowding on. I bicycled home through the traffic, proving to myself once again the wisdom of that choice of transportation.

But here we are, eight years later, still involved in two wars that were started because of that event, or at least that is what we are told. And just recently, Van Jones, the President’s green jobs advisor (or czar, as some people like to say), resigned in part because it was revealed he was one of the people who signed a petition that called for an investigation into whether the government deliberately allowed 9/11 to happen so it could have an excuse to go to war in Afghanistan and/or Iraq.

Now I have mentioned before and elsewhere that I remember Paul O’Neill had divulged in his book (The Price of Loyalty, I think) that there had been memos in early 2001 talking about a post-Saddam Iraq. By itself that’s not a smoking gun, but it ought to be strong enough evidence to support a call for an investigation. And O’Neill was saying this in 2004, when this petition came out. The petition Jones signed publically was actually circulated to a weird variety of 100 prominent Americans, such as Ed Asner and various types of professors and businessmen. The names have been posted on a website since, for all to see. And apparently Jones has since decided maybe he doesn’t agree with the idea that the Bush administration might have deliberately not acted when it learned of the possible terrorist danger. But when Glenn Beck started foaming at the mouth about this and other things Jones has done (like deciding he was a communist for a while), Jones resigned rather than be a distraction for the Obama administration.

An African American resigns from the administration of the first African American President in part because he called for an impartial investigation into the actions of the government before the terrorists attacks of 9/11. He resigns because calling for this investigation offends a white male television personality. This television personality answers only to his network, he has essentially zero accountability with the American public, yet he is able to twist what should be a free speech issue into a liability. The very freedoms that conservatives claim the terrorists hate us for are the ones conservatives want to take away from us, starting with a minority group that spent the first hundred or so years of this country’s existence in chains.

Then, when the President is speaking to a joint session of Congress about health care and the lack of a civil debate, a Congressman interrupts him to tell the President he is lying (concerning whether undocumented workers will receive subsidized healthcare). Americans, in the form of organizations or individuals, well known or ordinary, line up in public forums to either say the Congressman’s behavior was wrong and/or he was wrong on the facts, or to say the Congressman was bravely standing up to a dangerous President.

That division is emblematic of the state of the country, before and soon after 9/11. I personally blame the conservatives who seemed to develop a standard for being a good American, that started with agreeing with and supporting the President in a time of war. They also used broad stereotypes and misinformation to advance their agendas. Although President Bush has left office, those who in the past disagreed with him are still being judged by this standard. Those who support Barack Obama are being judged by a new standard, that of worshiping a false god. Liberals, incensed and infuriated by these standards and other behaviors of conservatives, have hardened their own positions and condemn those who still wish to work with conservatives, including, ironically, our current President.

It’s possible the Chinese should add a new curse besides “May you live in interesting times”. The new one would be “May you live in ironic times”.

When I graduated from college and came back to Pittsburgh, I registered as a Republican. At the time, I thought I might try to do something in politics, and I had two reasons for choosing the Republicans. First is the small pond thing (I thought I might become a big fish, if I wasn’t one to start with) and then there is the popular stereotype that Republicans know a lot about economics. Now, I had read an academic article in college which said that politicians and staffers of both parties knew the words used by economists, but didn’t understand the concepts. But here I was, with majors in political science and economics, so I could change all that. Except I quickly realized the Republicans are largely a joke in Pittsburgh (particularly in the mid 80’s), and I never looked too hard for meetings or events.

Now I am registered Democrat but I feel they are closer (although not the same as) to my social views. But one reason I read David Brooks in the NYTimes is that he seems to want to embody the stereotype of Republicans/conservatives as smart on economics (the “party of ideas”). So I was interested in his take on Obama’s health care speech. And it did not disappoint.

Before I go on, I think that while Brooks writes as if he is thoughtful and concerned with facts and ideas, he is a conservative. I don’t know exactly what his agenda is, but on healthcare I see him as part of the problem, in a subtle way. I think around mid summer he picked up the theme that a majority of Americans oppose the leading House bill (which Brooks likes to link to the President). I think the truth is much more complicated than that, and not helped by the shallow coverage of those in the media, including Brooks.

So I was interested to see Brooks say that Wednesday’s speech was “the finest speech of his presidency”. However, Brooks quickly made it clear that he thought Obama’s speech was so good because Brooks thought Obama had moved to the center, and, dare I say it, is not following Brooks’ advice. So Brooks praised Obama saying he would not sign a bill that raises the deficit by even one dime. In Brooks mind, that means the House bill is dead, and whatever Max Baucas (sp?) lobs at us is what is likely to be signed. Brooks thought Obama dropped the Public Option (not what I took away at all), and praised Obama arguing for tort reform (which I agree Obama did).

I have to say on the public option I have seen at least a couple of people say that they thought Obama indicated he was willing to drop it. I personally got the sense that Obama was willing to drop it only if the droppers proposed something that would achieve a minimum result equivalent to what the public option would achieve. In other words, Obama doesn’t care so much how it is done, but he wants that credible competition to private insurers. And I believe he indicated he won’t sign a bill without it.

But I dare say that I think Brooks, while wrong in my opinion in several parts of his column, was quite right in calling Obama’s speech the finest of his Presidency. Overtly it had some things for almost every one, between the strong call for reform but also identifying part of that as tort reform, he was like a piñata of treats for both parties. But on a more subtle level, I think Obama succeeded in convincing his audience that no matter who they are, Obama respects their opinion. It certainly seemed to work on David Brooks. Brooks may be in for a nasty shock in a few weeks, but for now he is a big, if unlikely, Obama supporter.

Wednesday, September 09, 2009

And before I read anybody else's analysis, I thought I would venture my own. First I will say I realize that Chad Hermann (and his minions) will pick apart the President’s speech line by line, finding it wanting piece meal and as a whole. And any one who says anything positive about the President’s speech is a dupe in thrall to the mystique of Obama the messiah. But anyone who criticizes him is part of a persecuted minority (of people with common sense), who are being accused of racism by the actual racists, the liberals (actually closet communists) whose arguments are so weak they have to resort to name calling and twisting the facts.

And so you should ignore anything I say here, because it will all be useless drivel.

Anyhoo, I thought the President gave a good speech. He continues to walk a fine line, between reinforcing his base, trying to include the Republicans in on things and actually do something to achieve health care reform. He started by introducing the problem, citing the costs in lives and dollars. He then stated he is going to give Congress a bill (that’s the way I understood it) and he outlined what will be in it, including an insurance exchange for the uninsured. Then he spent some time correcting (attacking?) the misinformation we have had forced on us in the last month. Only then did he mention the public option. He waited so long I thought he had dropped the public option. He did specify the limitation that only people who don’t have insurance now will be able to use it. He said that only 5% of Americans might sign up for it (according to the CBO). But I will say the public option could, in fact, be a powerhouse in health insurance. The private companies keep as much as 20% of premiums for overhead (mostly for profit). The public option might only keep 3%. So they might be able to pay somewhat more for medical claims and still have lower premiums. This cold affect the bottom line of private insurers, and cause them to either keep less of premiums and lower costs to consumers, or to lobby the Republicans hard to block the plan. On the other hand, if the public option really is only for the currently uninsured, well, they weren’t buying private insurance before anyway, so how much have the private companies lost?

Back to the President’s speech, it went on. And on. He said finally at least three times, I think, yet it kept on not being finally. He said we wouldn’t insure illegal aliens, which yielded a yelled “lie” from the Republican side (Nancy Pelosi glared for some time over that way), and some other dubious noises, some I think from Democrats. He pointedly did not mention a tax on those making over $250,000, although Obama did mention the Bush tax cuts for the wealthy, as well as the two wars Obama inherited, as adding to the deficit Obama inherited (to enthusiastic Democratic only applause). And Obama did pointedly reassure senior citizens that he was not going to make them suffer any hardship.

He finished with an extended discussion that started with a letter Teddy Kennedy wrote in May but somehow was delivered to Obama only recently (that’s the way I understood what Obama said). He focused on a phrase Kennedy used, the American character. And Obama drew out his analysis, talking about the tension between individual liberty and having government step in when either the free market has failed or maybe when some problem, natural disaster or man made, has occurred. Obama stressed the importance of individual liberty, but came down particularly in this situation on a greater role for government.

Now, if you think about it, bringing up the issue of individual liberty with reference to health insurance is entirely silly. Most of us experience health insurance through our employer, where we are either offered one plan, period, or perhaps a cafeteria of plans. My employer has six or maybe seven or eight plans, each with different costs depending on family size. Despite that fairly impressive variety, I don’t thing there is a true High Deductible/Health Savings Account plan in there (the plan has to meet certain deductible levels to qualify for the tax benefits, which are key). By the way, I have decided now that HD/HAS plans are only good for young people (preferably just out of college) who plan to never have children. That’s means pushing HD/HSA’s means having your country shrink.

Anyway, my point is that even for me, my choices are pretty limited. But I am steered toward those limited choices because my employer will pay some 70% of my premiums. Even if I were to buy my own health insurance, my choices would be pretty limited to what is available around here. And if I try to shop around for doctors, I quickly find I am pushed toward health insurance options where I choose from a limited pool of doctors, ones heavily affiliated with my health insurance company. Plus, for shopping either for health insurance companies or doctors, the rates they charge are largely concealed. So any shopping will be made that much more difficult, and if you (and you spouse if you are married) work, it will be even more difficult since your work would have to tolerate your calling health insurance companies and/or doctors during work hours, and staying on the phone for a pretty long time.

So any sense that the free market of health insurance and health care actually gives you choices is in practice simply wrong. Despite that, Obama is trying to maintain part of the status quo (despite what he says) because it works for a majority of Americans. The majority doesn’t have to think too hard about their health insurance, and doesn’t want to.

I think Obama is taking a wise approach, and I think he made that clear in his (long) speech tonight (clearer than in my long post here). But I think the day is coming when we will decide to take the single payer route. And the longer we delay, the more suffering that will occur along the way.

Sunday, September 06, 2009

I just watched that Al Franken video on health care, and I was not hugely impressed given the build up, but it was interesting enough to watch. One question stuck with me. Someone asked how we are going to pay for the cost of the bill. Well, my immediate thought was that we are paying for it now. We are paying for the uninsured with the higher costs charged by hospitals and doctors now. If you can't pay, emergency rooms are obliged to treat you anyway. Then, afterwards, assuming you survive, they will send you bills, which you might try to pay until you go bankrupt, or which you might ignore. The collection agencies will destroy your credit rating, and the hospital will write off the costs. That will mean lower taxes if they are a for profit, but the stockholders might replace the hospital CEO for someone less likely to lose money. Non-profits might have a bit more leeway, but still can't afford to give away too much care. And meanwhile for or non profits will raise their prices to cover these kinds of cost in the future. Those higher prices are paid for by health insurance companies now. You employer may shield you from 80 to 90 % of the premium, but your employer has to make up for that with higher prices for their customers (currently employers and you do get a tax deduction for health insurance premiums, but the Republicans want to end that). So we do pay for care for the uninsured now, only very inefficiently, and with lots of death and bankruptcy.

A single payer system would improve health outcomes and lower costs even further. Taxes would go up, but your paycheck should also go up, and the prices for things should go down. Actually, while I thick every one's pay would go up, I think prices would stay the same, just not rising as much for a few years. That even though there would be a spike in demand caused by the higher pay.

Saturday, September 05, 2009

Well, I had stole Kyle Chandler’s Sunday paper and got the chance to write about Jack Kelly’s column before most other bloggers or whom ever would bother. But I squandered that chance by being busy this afternoon and lazy this evening. Which is a shame because I think the subject matter of Kelly’s column is pretty important. He talked this Sunday about Afghanistan and how Obama should conduct that war.

Kelly starts the column agreeing that in fact Bush did screw up the Afghan war, by not giving it enough attention. That’s probably true, but it is surprising to see Kelly say it. But the big issue is whether Obama should add troops. Kelly does not actually take a stand on that, instead he says things like that adding troops is the only way to win the war, but if Obama does it becomes Obama’s war. He also says that not adding troops might keep the war out of the public eye, but would backfire shortly.

Kelly also at one point snarks that just adding troops won’t win the war by itself, we need to apply the lessons of Iraq to Afghanistan. He also decides at the end of the column to agree with a retired intelligence officer and suggest that we pull most of out troops out, and simply use drones and special forces to kill terrorists.

Columns like this make me think back to the Civil War, when Lincoln kept McClellan on as a general for way too long. Everyone goes into battle planning on winning, but wishing or even ordering your generals to win won’t make it happen. You need to have experienced people who are comfortable in battle, and of course we should have people like that now.

But I keep thinking of the Soviets, who invaded Afghanistan in December of 1979, and left ten years later. They had a 100,000 men there, not as well equipped, well trained or well motivated as our troops, but more willing to be brutal to win the conflict. And they couldn’t.

Honestly I don’t know what the answer for Afghanistan is. We have a vested interest in eliminating the poppy trade, but the Afghans have a bigger interest in continuing the trade. And even though Jack Kelly complains about our treating the Pakistanis as allies and Kharzai (sp?) as a good guy, you have to go with the facts on the ground. Treating Kharzai as a corrupt politician does not help us much, and cutting ourselves off from Pakistan means losing access to the Taliban

I don’t think Kelly advanced the dialogue this week, but he did less than usual to hurt it.